Hospitals in Ohio and at least 14 other states have forced undocumented immigrant patients who were injured or sick to return to their home countries, according to a recent report.

“I think most people have no idea that this is going on,” said Lori Nessel, the director of the Center for Social Justice at Seton Hall University in South Orange, N.J., who worked on the study. “Just because someone is undocumented from an immigration perspective in this country, the hospital can’t endanger them when they’re at their most vulnerable.”

In central Ohio, Ohio State University’s Wexner Medical Center and Mount Carmel Health System said they have sent undocumented immigrants back to their home countries. Neither would describe the circumstances.

The practice, called “medical repatriation,” gained news-media attention last month after an Iowa hospital’s handling of the care of two Mexican immigrants came to light.

The men had been badly injured in a car crash in 2008 and were taken to a Des Moines hospital, according to the Associated Press. They had health insurance through their jobs at a large pork producer. But they did not have legal permission to live in the United States, and it wasn’t clear that their health insurance would cover long-term rehabilitation.

The hospital consulted with the patients’ families, then loaded the two comatose men onto a private jet that flew them back to Mexico. No court or federal agency was consulted, according to the AP.

The Center for Social Justice said it found evidence of more than 600 such removals by hospitals over a five-year period but that the number of cases likely is higher.

In one case, Nessel said, an undocumented immigrant from Guatemala had serious complications with her pregnancy and went to an unspecified Ohio hospital for care. The hospital told the woman she would need to return to Guatemala, Nessel said.

Immigration laws prevent the majority of “repatriated” undocumented immigrants from returning to the United States, according to the report.

Local hospitals said they don’t have policies that specifically address medical repatriations.

Mount Carmel Health System spokesman Jason Koma said the hospital system has encountered the situation “a few times,” most recently two years ago. In one case, a patient was sent home to Mexico, but only after the hospital system contacted the Mexican consulate, Koma said.

“It’s my understanding that all the proper channels were followed,” he said. He declined to give details, citing patient-privacy concerns.

Wexner Medical Center gave few details of how it has handled medical repatriation, writing in a prepared statement: “On the rare occasion when we encounter these situations, we work with our patients and their families in order to find appropriate resources to assist the patient in returning to their home country.”

The medical center said that, under Ohio law, it cannot use state money to pay for an individual’s flight home.

In a statement, Nationwide Children’s Hospital said it would handle such situations “on a case-by-case basis, depending on what is best for the child.”

“Once a child comes to Nationwide Children’s Hospital for care, regardless of resources or country of origin, we provide the care that they need. We would assist with coordination of care in returning to their home country or state, if that would be best for the child and the family.”

A Children’s spokeswoman said no officials she checked with “could remember a time when this happened here.”

OhioHealth spokesman Mark Hopkins said the hospital system, which includes Grant Medical Center and Riverside Methodist Hospital, “wouldn’t send anyone unconscious anywhere,” nor against their will. Hopkins said officials there could recall no repatriation cases.

Medical repatriation highlights a need for greater oversight and regulation by the federal government, Nessel said.

And no state laws that regulate “informed consent,” including Ohio’s, deal squarely with medical repatriation, said Shena Elrington, a co-author of the report who works at New York Lawyers for the Public Interest, a civil-rights law firm.